How to manage and reduce stress

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Here, we would like to start, by giving you an introduction to what stress is, what the signs of stress are, what simple steps you can take when feeling stressed and provide practical advice for preventing it, to show why we are passionate about moving towards a less stressed nation.

What is stress?

Stress is a feeling of being under abnormal pressure. This pressure can come from different aspects of your day to day life. Such as an increased workload, a transitional period, an argument you have with your family or new and existing financial worries. You may find that it has a cumulative effect, with each stressor building on top of one another.

During these situations you may feel threatened or upset and your body might create a stress response. This can cause a variety of physical symptoms, change the way you behave, and lead you to experience more intense emotions.5

Stress affects us in a number of ways, both physically and emotionally and in varying intensities.1

How can I identify the signs of stress?

Everyone experiences stress. However, when it is affecting your life, health and wellbeing, it is important to tackle it as soon as possible, and while stress affects everyone differently, there are common signs and symptoms you can look out for:15

feelings of constant worry or anxiety

feelings of being overwhelmed

difficulty concentrating

mood swings or changes in your mood

irritability or having a short temper

difficulty relaxing

depression

low self-esteem

eating more or less than usual

changes in your sleeping habits

using alcohol, tobacco or illegal drugs to relax

aches and pains, particularly muscle tension

diarrhoea and constipation

feelings of nausea or dizziness

loss of sex drive.

If you are experiencing these symptoms for a prolonged period, and feel they are affecting your everyday life or are making you feel unwell, you should speak to your GP. You can ask for information about the support services and treatments available to you.

Three steps to take when feeling stressed

1. Realise when it is causing you a problem

Try to make the connection between feeling tired or ill and the pressures you are faced with

Look out for physical warnings such as tense muscles, over-tiredness, headaches or migraines38

2. Identify the causes

Try to identify the underlying causes

Sort the possible reasons for your stress into three categories 1) those with a practical solution 2) those that will get better given time and 3) those you can’t do anything about

Try to release the worry of those in the second and third groups and let them go

3. Review your lifestyle

Could you be taking on too much?

Are there things you are doing which could be handed over to someone else?

Can you do things in a more leisurely way?

To act on the answer to these questions, you may need to prioritise things you are trying to achieve and re-organise your life

This will help to release pressure that can come from trying to do everything at once

Seven steps to help protect yourself from stress

1. Eat healthily

Eating healthily can reduce the risks of diet-related diseases39

There is a growing amount of evidence showing how food affects our mood40 and how eating healthily can improve this

You can protect your feelings of wellbeing by ensuring that your diet provides adequate amounts of brain nutrients such as essential vitamins and minerals, as well as water41

2. Be aware of smoking and drinking alcohol

Try not to, or reduce the amount you smoke and drink alcohol

Even though they may seem to reduce tension initially, this is misleading as they often make problems worse42

3. Exercise

Try and integrate physical exercise into your lifestyle as it can be very effective in relieving stress

Even just going out and getting some fresh air, and taking some light physical exercise, like going for a walk to the shops can really help43

4.Take time out

Take time to relax

Strike the balance between responsibility to others and responsibility to yourself, this can really reduce stress levels

Tell yourself that it is okay to prioritise self-care · Are you needing time out but saying 'I just can't take the time off', if so read more about how taking a break is important for good mental health

5. Be mindful

Mindfulness is a mind-body approach to life that helps us to relate differently to experiences. It involves paying attention to our thoughts and feelings in a way that increases our ability to manage difficult situations and make wise choices

Try to practice mindfulness regularly

Mindfulness meditation can be practiced anywhere at any time

Research has suggested that it can reduce the effects of stress, anxiety and related problems such as insomnia, poor concentration and low moods, in some people44

Our Be Mindful website features a specially developed online course in mindfulness, as well as details of local courses in your area

6. Get some restful sleep

Are you finding you are struggling to sleep? This is a common problem when you’re stressed45

Could your physical or mental health be impacting your ability to sleep?

Could you amend your environment to help improve your sleep?

Could you get up instead of staying in bed when your mind is worrying at night?

Could you make small changes to your lifestyle to help your get a restful sleep?

7. Don’t be too hard on yourself

When your inner critic or an outer critic finds faults, try and find truth and exception to what is being said

If you stumble or feel you have failed, don’t beat yourself up

Act as if you were your own best friend: be kind and supportive

Take a few minutes each day to appreciate yourself

Now, we would like to move on to a more detailed look at the causes and effects of stress. In this section we will focus on the effects prolonged stress has on your body, behaviour and emotions, and look at key causes such as relationships, money, work, alcohol and drug use.

Can stress be positive?

Research has shown that stress can sometimes be positive. It can make you more alert and help you perform better in certain situations.2 However, stress has only been found to be beneficial if it is short-lived.

Excessive or prolonged stress can contribute to illness such as heart disease3 and mental health problems such as anxiety and depression.4

What can prolonged stress lead to?

Stress is a natural reaction to many situations in life, such as work, family, relationships and money problems.

We mentioned earlier on that a moderate amount of stress can help us perform better in challenging situations,34 but too much or prolonged stress can lead to physical problems. This can include lower immunity levels,35 digestive and intestinal difficulties, e.g. irritable bowel syndrome (IBS),36 or mental health problems such as depression.3 This means it is important to manage your stress and keep it at a healthy level to prevent long-term damage to your body and mind.

What happens to my body when I experience stress?

People react differently to stress. Some common symptoms of stress include sleeping problems, sweating or a change in appetite.6,7

Symptoms like these are triggered by a rush of stress hormones in your body which, when released, allow you to deal with pressures or threats. This is known as the 'fight or flight' response.

Hormones called adrenaline and noradrenaline raise your blood pressure, increase your heart rate and increase the rate at which you perspire. This prepares your body for an emergency response.8 These hormones can also reduce blood flow to your skin and reduce your stomach activity. Cortisol, another stress hormone, releases fat and sugar into your system to boost your energy.9

As a result, you may experience headaches, muscle tension, pain, nausea, indigestion and dizziness. You may also breathe more quickly, have palpitations or suffer from various aches and pains. In the long-term, you may be putting yourself at risk from heart attacks and stroke.10

All these changes are your body’s way of making it easier for you to fight or run away and once the pressure or threat has passed, your stress hormone levels will usually return to normal.11 However, if you’re constantly under stress, these hormones remain in your body, leading to the symptoms of stress. If you’re stuck in a busy office or on an overcrowded train, you can’t fight or run away, so you can’t use up the chemicals your own body makes to protect you. Over time, the build-up of these chemicals and the changes they produce can be damaging for your health.12

What are the behavioural and emotional effects of stress?

When you are stressed you may experience many different feelings, including anxiety, irritability or low self-esteem, which can lead to becoming withdrawn, indecisive and tearful.13

You may experience periods of constant worry, racing thoughts, or repeatedly go over the same things in your head. You may experience changes in your behaviour. You may lose your temper more easily, act irrationally or become more verbally or physically aggressive.14 These feelings can feed on each other and produce physical symptoms, which can make you feel even worse. For example, extreme anxiety can make you feel so unwell, that you then worry you have a serious physical condition.

What causes stress?

All sorts of situations can cause stress. The most common involve work, money matters and relationships with partners, children or other family members.

Stress may be caused either by major upheavals and life events such as divorce, unemployment, moving house and bereavement, or by a series of minor irritations such as feeling undervalued at work or arguing with a family member.16Sometimes, there are no obvious causes.

Relationships and stress

Relationships are a great support in times when we feel stressed. However, from time to time the people close to you, be it a partner, parent, child, friend or colleague, can increase your stress levels.17

Relationships, the missing piece of the wellbeing puzzle

We explored relationships for Mental Health Awareness Week 2016 and how good relationships are vital for our mental health. Watch our animation now:

Events such as ongoing minor arguments and disagreements, to larger family crises, such as an affair, illness or bereavement are likely to affect the way you think, feel and behave. This may consequently have an impact on your stress levels.

Work-life balance and stress

The pressure of an increasingly demanding work culture in the UK is one of the biggest contributors to stress among the general population.18

While traditional working hours are 37 hours a week, the recent and dramatic rise in Britain’s working hours suggests this is likely to increase. 20.1% of the UK working population work 45 hours or more per week.19

The human costs of unmanaged work related stress is extensive. Feeling unhappy about the amount of time you spend at work and neglecting other aspects of life because of work may increase your vulnerability to stress. Increased levels of stress can, if not addressed early enough, lead to burn-out or more severe mental health problems.

Mental health issues such as anxiety and depression, are thought to be the leading cause of work absences, accounting for up to 40% of sickness leave.20 In 2008, mental health accounted for 442,000 cases of work-related illnesses and has had an estimated cost of 13.5 million.21 As a result, mental ill health now accounts for a significant proportion of long-term sickness and early retirement, cited as the leading cause of illness for 20% of NHS employees.22

Money and stress

Money and debt concerns place huge pressure on us, so it comes as no surprise that they have a marked effect on our stress levels.

The effects of the economic crisis have affected everyone in some capacity. Recent statistics from StepChange Debt Charity found an increased demand of 56% for debt advice and support from 2012-2014.23 Citizens Advice have seen a similar increase in the number of people experiencing stress about finances, dealing with 6,407 debt problems every working day.24

A survey conducted in 2013 found that 42% of those seeking debt help had been prescribed medication by their GP to help them cope, while 76% of those in a couple said debt had affected their relationship.25

The combination of chronic stress and debt can result in depression and anxiety,26 and has been highlighted as a factor linked to suicidal thoughts and attempts.27

Helpful organisations for money worries

It is important if you are worried about your finances and debts that you do not try to deal with them alone. There is a lot of help and support available to you through organisations such as Step Change and Citizens Advice.

You should also talk to your GP or a trusted health professional if you are worried about how debt is affecting your mental and physical health.

Smoking, drinking and drug use and stress

You might find that you smoke, drink alcohol or use recreational drugs to reduce stress. However, this often makes problems worse.28

Research shows that smoking may increase feelings of anxiety.29 Nicotine creates an immediate, temporary, sense of relaxation, which can then lead to withdrawal symptoms and cravings.

Similarly, you may use alcohol as a means to manage and cope with difficult feelings, and to temporarily reduce feelings of anxiety. However, alcohol may make existing mental health problems worse. It can make you feel more anxious and depressed in the long run.30 It is important to know the recommended limits31 and drink responsibly.

Prescription drugs, such as tranquillisers and sleeping tablets, which may have been prescribed for very good reasons, can also cause mental and physical health problems if used for long periods of time.32 Street drugs, such as cannabis or ecstasy, are usually taken for recreational purposes. For some people, problems start as their bodies get used to repeated use of the drug. This leads to the need for increased doses to maintain the same effect.33

How can you help yourself?

Stress is a natural reaction to many situations in life, such as work, family, relationships and money problems.

We mentioned earlier on that a moderate amount of stress can help us perform better in challenging situations,34 but too much or prolonged stress can lead to physical problems. This can include lower immunity levels,35 digestive and intestinal difficulties, e.g. irritable bowel syndrome (IBS),36 or mental health problems such as depression.37 It is therefore important that we manage our stress and keep it at a healthy level to prevent long-term damage to our bodies and minds.

Remember to seek help and support when you need it

Remember, that it is okay to ask for professional help. If you feel that you are struggling to manage on your own, then you can reach out. It is important to know that you can get help as soon as possible, and that you deserve to get better.

The first person to approach is your family doctor. He or she should be able to give advice about treatment, and may refer you to another local professional. Cognitive Behavioural Therapy (this is a type of therapy that works by helping you to understand that your thoughts and actions can affect the way you feel) and Mindfulness based approaches are known to help reduce stress. There are also a number of voluntary organisations which can help you to tackle the causes of stress and advise you about ways to get better.

Samaritans

Specialist mental health services

There are a number of specialist services that provide various treatments, including counselling and other talking treatments. Often these different services are coordinated by a community mental health team (CMHT), which is usually based either at a hospital or a local community mental health centre. Some teams provide 24-hour services so that you can contact them in a crisis. You should be able to contact your local CMHT through your local social services or social work team.